| NPI | 1114067196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61498906) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P4471) |
| 208600000X Surgery (Licence: TX P4471) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX P4471) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2025-03-24 |